Burcu ARTUNÇ ÜLKÜMEN, Eralp ÇAVİKKALP, Beyhan CENGİZ ÖZYURT, Gülay OK, Koray ERBÜYÜN, Pınar SOLMAZ HASDEMİR, Demet AYDIN

Sezaryen Sonrası Farklı Yöntemlerin Arasında Postoperatif Analjezik Etkinliğin Karşılaştırılması

Amaç: Bu araştırmada, sezaryen yapılan olgularda, genel anesteziye eklenen transversus abdominis plan bloğu (TAP) ile epidural anestezi ve spinal anestezinin postoperatif analjezik etkileri karşılaştırıldı. Sezaryen ameliyatı sonrası TAP bloğun etkinliği belirlenmeye çalışıldı. Yöntem: Etik Kurul (25.03.2015/142) izni alındıktan sonra, elektif şartlarda sezaryen planlanan olgular, spinal anestezi, epidural anestezi ve genel anestezi olmak üzere 3 gruba ayrıldı. Bu araştırma, genel anesteziye eklenen TAP yapılan 30 olgu (Grup T) ile epidural anestezi yapılan 32 olgu (Grup E) ve spinal anestezi yapılan 30 olgu (Grup S) olmak üzere toplam 92 olgudan oluşmaktadır. Tüm olgulara ameliyat bitiminde diklofenak sodyum 75 m IM uygulandı.Olguların postoperatif ağrılarının ne zaman başladığı ve Görsel Analog Skala (GAS)’ya göre hangi şiddette olduğu ve olguların ek analjezik gereksinimleri ile postoperatif 0. saat, 1. saat, 4. saat 6. saat ve 12. saatteki kalp atım hızı, kan basıncı, periferik O2 saturasyonu, solunum sayıları ile görülen yan etkiler kaydedildi. Postoperatif dönemde olguların ek analjezik gereksinimleri olduğunda 50 mg tramadol IV uygulandı. Bulgular: Postoperatif analjezik gereksinimi açısından gruplar arasında anlamlı bir fark bulunmadı (Tablo II). Grup T’de de Grup S’ye göre daha az tramadol tüketimi gerçekleşmiştir (p

Comparison of Postoperative Analgesic ID Efficacy of Different Methods After Cesarean-Section

Objective: In this research study,we compared postoperative analgesic effects of general anesthesiafollowed with transversus abdominis plane block (TAPB), epidural or spinal anesthesia andwe aimed to figure out the efficacy of TAPB for the postoperative pain.Method: After approval of the ethics committee (date: 03.25.2015; decision no: 142) for thestudy was obtained, the study population scheduled for elective cesarean operations was dividedin three subgroups as spinal, epidural and general anesthesia. Group T consisted of 30 cases thatunderwent general anesthesia and TAP; Group E consisted of 32 cases that underwent epiduralanesthesia; and Group S consisted of 30 cases that underwent spinal anesthesia. All casesreceived 75 mg IM diclophenac sodium after the operation. Data about the postoperative pain(the onset time of the pain, and the severity of the pain evaluated with VAS (Visual Analog Scale)and the need for adjuvant analgesics) were recorded. In addition, heart rate, blood pressure,peripheric oxygen saturation, respiration rates at postoperative 0., 1., 4., 6. and 12. hours andside effects seen were recorded. If the patient needed any additional postoperative analgesics,50 mg tramadol was injected intravenously.Results: There was no significant difference between the groups regarding postoperative analgesianeed (Table II). The need for postoperative tramadol was minimum for patients in Group E andmaximum for patients in Group S (p

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